{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T05:05:34Z","timestamp":1787893534508,"version":"build-2784847793"},"reference-count":30,"publisher":"Springer Science and Business Media LLC","issue":"3","license":[{"start":{"date-parts":[[2025,1,21]],"date-time":"2025-01-21T00:00:00Z","timestamp":1737417600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,1,21]],"date-time":"2025-01-21T00:00:00Z","timestamp":1737417600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100010586","name":"Haukeland\u00a0Universitetssjukehus","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100010586","id-type":"DOI","asserted-by":"publisher"}]},{"name":"University of Bergen"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Arch Otorhinolaryngol"],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Introduction<\/jats:title>\n            <jats:p>Exercise- Induced Laryngeal Obstruction (EILO) can lead to disabling exercise related dyspnea and hamper participation in physical activity. In this study, we aimed to investigate the effects of a standardized speech therapy protocol as treatment for EILO.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>Patients diagnosed with EILO at our institution were invited to participate. We compared laryngeal findings obtained during a continuous laryngoscopy exercise (CLE) test and questionnaire based self-reported breathing symptoms, before vs. after the treatment intervention. The laryngeal obstruction was characterized using a standardized CLE scoring system (0\u201312 points).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>A total of 28 patients were evaluated. Following speech therapy, the mean reduction in the CLE score was 1.5 (95% confidence interval: 1.1\u20132.0) points, with the improvement primarily associated with decreased glottic-level obstruction. Twenty-four (86%) patients reported reduced symptoms during exercise. A moderate correlation was observed between changes in CLE scores and subjective symptom improvements.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>This study suggests that a standardized speech therapy protocol reduces observed laryngeal obstruction during the CLE test, with the most notable improvement occurring at the glottic level, alongside a parallel reduction in self-reported symptoms of EILO.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00405-024-09190-y","type":"journal-article","created":{"date-parts":[[2025,1,21]],"date-time":"2025-01-21T10:57:08Z","timestamp":1737457028000},"page":"1345-1354","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Speech therapy for exercise-induced laryngeal obstruction"],"prefix":"10.1007","volume":"282","author":[{"given":"Kristine","family":"Vreim","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom","family":"Karlsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Petter Hel\u00f8","family":"Carlsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valgjerd Helene","family":"Nistad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ola Drange","family":"R\u00f8ksund","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1471-0225","authenticated-orcid":false,"given":"Thomas","family":"Halvorsen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Volls\u00e6ter","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John-Helge","family":"Heimdal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hege","family":"Clemm","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mette","family":"Engan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,1,21]]},"reference":[{"issue":"1","key":"9190_CR1","doi-asserted-by":"publisher","first-page":"57","DOI":"10.1136\/thoraxjnl-2014-205738","volume":"70","author":"H Johansson","year":"2015","unstructured":"Johansson H, Norlander K, Berglund L, Janson C, Malinovschi A, Nordvall L et al (2015) Prevalence of exercise-induced bronchoconstriction and exercise-induced laryngeal obstruction in a general adolescent population. Thorax 70(1):57\u201363","journal-title":"Thorax"},{"issue":"9","key":"9190_CR2","doi-asserted-by":"publisher","first-page":"1313","DOI":"10.1007\/s00405-011-1612-0","volume":"268","author":"PM Christensen","year":"2011","unstructured":"Christensen PM, Thomsen SF, Rasmussen N, Backer V (2011) Exercise-induced laryngeal obstructions: prevalence and symptoms in the general public. Eur Arch Otorhinolaryngol 268(9):1313\u20131319","journal-title":"Eur Arch Otorhinolaryngol"},{"issue":"4","key":"9190_CR3","doi-asserted-by":"publisher","first-page":"1781","DOI":"10.1007\/s00405-016-4338-1","volume":"274","author":"S Liyanagedera","year":"2017","unstructured":"Liyanagedera S, McLeod R, Elhassan HA (2017) Exercise induced laryngeal obstruction: a review of diagnosis and management. Eur Arch Otorhinolaryngol 274(4):1781\u20131789","journal-title":"Eur Arch Otorhinolaryngol"},{"issue":"12","key":"9190_CR4","doi-asserted-by":"publisher","first-page":"1929","DOI":"10.1007\/s00405-009-1030-8","volume":"266","author":"RC Maat","year":"2009","unstructured":"Maat RC, R\u00f8ksund OD, Halvorsen T, Skadberg BT, Olofsson J, Ellingsen TA et al (2009) Audiovisual assessment of exercise-induced laryngeal obstruction: reliability and validity of observations. Eur Arch Otorhinolaryngol 266(12):1929\u20131936","journal-title":"Eur Arch Otorhinolaryngol"},{"issue":"137","key":"9190_CR5","doi-asserted-by":"publisher","first-page":"445","DOI":"10.1183\/16000617.00006513","volume":"24","author":"PM Christensen","year":"2015","unstructured":"Christensen PM, Heimdal JH, Christopher KL, Bucca C, Cantarella G, Friedrich G et al (2015) ERS\/ELS\/ACCP 2013 international consensus conference nomenclature on inducible laryngeal obstructions. Eur Respir Rev 24(137):445\u2013450","journal-title":"Eur Respir Rev"},{"issue":"3","key":"9190_CR6","doi-asserted-by":"publisher","first-page":"1602221","DOI":"10.1183\/13993003.02221-2016","volume":"50","author":"T Halvorsen","year":"2017","unstructured":"Halvorsen T, Walsted ES, Bucca C, Bush A, Cantarella G, Friedrich G et al (2017) Inducible laryngeal obstruction: an official joint European Respiratory Society and European Laryngological Society statement. Euro Respir J 50(3):1602221","journal-title":"Euro Respir J"},{"issue":"1","key":"9190_CR7","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1097\/01.mlg.0000184528.16229.ba","volume":"116","author":"JH Heimdal","year":"2006","unstructured":"Heimdal JH, Roksund OD, Halvorsen T, Skadberg BT, Olofsson J (2006) Continuous laryngoscopy exercise test: a method for visualizing laryngeal dysfunction during exercise. Laryngoscope 116(1):52\u201357","journal-title":"Laryngoscope"},{"key":"9190_CR8","first-page":"86","volume":"21","author":"OD R\u00f8ksund","year":"2017","unstructured":"R\u00f8ksund OD, Heimdal JH, Clemm H, Volls\u00e6ter M, Halvorsen T (2017) Exercise inducible laryngeal obstruction: diagnostics and management. Paediatr Respir Rev 21:86\u201394","journal-title":"Paediatr Respir Rev"},{"issue":"2","key":"9190_CR9","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1016\/j.iac.2018.01.003","volume":"38","author":"M Shaffer","year":"2018","unstructured":"Shaffer M, Litts JK, Nauman E, Haines J (2018) Speech-language pathology as a primary treatment for exercise-induced laryngeal obstruction. Immunol Allergy Clin North Am 38(2):293\u2013302","journal-title":"Immunol Allergy Clin North Am"},{"issue":"1","key":"9190_CR10","doi-asserted-by":"publisher","DOI":"10.1136\/bmjsem-2018-000436","volume":"5","author":"A Sandnes","year":"2019","unstructured":"Sandnes A, Andersen T, Clemm HH, Hilland M, Volls\u00e6ter M, Heimdal JH et al (2019) Exercise-induced laryngeal obstruction in athletes treated with inspiratory muscle training. BMJ Open Sport Exerc Med 5(1):e000436","journal-title":"BMJ Open Sport Exerc Med"},{"issue":"3","key":"9190_CR11","doi-asserted-by":"publisher","first-page":"566","DOI":"10.1044\/2015_AJSLP-14-0120","volume":"24","author":"RR Patel","year":"2015","unstructured":"Patel RR, Venediktov R, Schooling T, Wang B (2015) Evidence-based systematic review: effects of speech-language pathology treatment for individuals with paradoxical vocal fold motion. Am J Speech Lang Pathol 24(3):566\u2013584","journal-title":"Am J Speech Lang Pathol"},{"issue":"1","key":"9190_CR12","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1044\/2022_AJSLP-22-00187","volume":"32","author":"MJ Sandage","year":"2023","unstructured":"Sandage MJ, Milstein CF, Nauman E (2023) Inducible laryngeal obstruction differential diagnosis in adolescents and adults: a tutorial. Am J Speech Lang Pathol 32(1):1\u201317","journal-title":"Am J Speech Lang Pathol"},{"issue":"4","key":"9190_CR13","doi-asserted-by":"publisher","first-page":"1517","DOI":"10.1044\/2023_AJSLP-22-00359","volume":"32","author":"RB Fujiki","year":"2023","unstructured":"Fujiki RB, Olson-Greb B, Braden M, Thibeault SL (2023) Therapy outcomes for teenage athletes with exercise-induced laryngeal obstruction. Am J Speech Lang Pathol 32(4):1517\u20131531","journal-title":"Am J Speech Lang Pathol"},{"issue":"9","key":"9190_CR14","doi-asserted-by":"publisher","first-page":"823","DOI":"10.1001\/jamaoto.2014.1405","volume":"140","author":"V De Guzman","year":"2014","unstructured":"De Guzman V, Ballif CL, Maurer R, Hartnick CJ, Raol N (2014) Validation of the dyspnea index in adolescents with exercise-induced paradoxical vocal fold motion. JAMA Otolaryngol-Head Neck Surg 140(9):823\u2013828","journal-title":"JAMA Otolaryngol-Head Neck Surg"},{"issue":"3","key":"9190_CR15","doi-asserted-by":"publisher","first-page":"727","DOI":"10.1002\/lary.23654","volume":"123","author":"T Chiang","year":"2013","unstructured":"Chiang T, Marcinow AM, deSilva BW, Ence BN, Lindsey SE, Forrest LA (2013) Exercise-induced paradoxical vocal fold motion disorder: diagnosis and management. Laryngoscope 123(3):727\u2013731","journal-title":"Laryngoscope"},{"issue":"10","key":"9190_CR16","doi-asserted-by":"publisher","first-page":"1751","DOI":"10.1097\/00005537-200110000-00016","volume":"111","author":"MD Sullivan","year":"2001","unstructured":"Sullivan MD, Heywood BM, Beukelman DR (2001) A treatment for vocal cord dysfunction in female athletes: an outcome study. Laryngoscope 111(10):1751\u20131755","journal-title":"Laryngoscope"},{"key":"9190_CR17","doi-asserted-by":"publisher","DOI":"10.1016\/j.jvoice.2024.06.005","author":"DJ Vos","year":"2024","unstructured":"Vos DJ, Milstein CF (2024) Long-term outcomes of respiratory retraining therapy for exercise-induced laryngeal obstruction. J Voice. https:\/\/doi.org\/10.1016\/j.jvoice.2024.06.005","journal-title":"J Voice"},{"key":"9190_CR18","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2024.1356476","author":"T Karlsen","year":"2024","unstructured":"Karlsen T, Vreim K, R\u00f8ksund OD, Volls\u00e6ter M, Muralitharan P, Ellingsen TA et al (2024) A speech therapy treatment protocol for exercise induced laryngeal obstruction. Front Pediatrics. https:\/\/doi.org\/10.3389\/fped.2024.1356476","journal-title":"Front Pediatrics."},{"issue":"3","key":"9190_CR19","doi-asserted-by":"publisher","first-page":"511","DOI":"10.1183\/09031936.05.00035005","volume":"26","author":"J Wanger","year":"2005","unstructured":"Wanger J, Clausen JL, Coates A, Pedersen OF, Brusasco V, Burgos F et al (2005) Standardisation of the measurement of lung volumes. Eur Respir J 26(3):511\u2013522","journal-title":"Eur Respir J"},{"issue":"1","key":"9190_CR20","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1016\/0002-9149(78)90134-0","volume":"41","author":"GR Cumming","year":"1978","unstructured":"Cumming GR, Everatt D, Hastman L (1978) Bruce treadmill test in children: normal values in a clinic population. Am J Cardiol 41(1):69\u201375","journal-title":"Am J Cardiol"},{"issue":"3","key":"9190_CR21","doi-asserted-by":"publisher","first-page":"00070-2017","DOI":"10.1183\/23120541.00070-2017","volume":"3","author":"ES Walsted","year":"2017","unstructured":"Walsted ES, Hull JH, Hvedstrup J, Maat RC, Backer V (2017) Validity and reliability of grade scoring in the diagnosis of exercise-induced laryngeal obstruction. ERJ Open Res 3(3):00070\u201302017","journal-title":"ERJ Open Res"},{"issue":"4","key":"9190_CR22","doi-asserted-by":"publisher","first-page":"284","DOI":"10.1097\/WNP.0000000000000187","volume":"32","author":"CL Ludlow","year":"2015","unstructured":"Ludlow CL (2015) Laryngeal reflexes: physiology, technique, and clinical use. J Clin Neurophysiol 32(4):284\u2013293","journal-title":"J Clin Neurophysiol"},{"issue":"2","key":"9190_CR23","doi-asserted-by":"publisher","first-page":"323","DOI":"10.1136\/annrheumdis-2014-206186","volume":"74","author":"S Lydersen","year":"2015","unstructured":"Lydersen S (2015) Statistical review: frequently given comments. Ann Rheum Dis 74(2):323\u2013325","journal-title":"Ann Rheum Dis"},{"issue":"5","key":"9190_CR24","doi-asserted-by":"publisher","first-page":"1763","DOI":"10.1213\/ANE.0000000000002864","volume":"126","author":"P Schober","year":"2018","unstructured":"Schober P, Boer C, Schwarte LA (2018) Correlation coefficients: appropriate use and interpretation. Anesth Analg 126(5):1763\u20131768","journal-title":"Anesth Analg"},{"issue":"9","key":"9190_CR25","doi-asserted-by":"publisher","first-page":"823","DOI":"10.1001\/jamaoto.2014.1405","volume":"140","author":"V De Guzman","year":"2014","unstructured":"De Guzman V, Ballif CL, Maurer R, Hartnick CJ, Raol N (2014) Validation of the dyspnea index in adolescents with exercise-induced paradoxical vocal fold motion. JAMA Otolaryngol Head Neck Surg 140(9):823\u2013828","journal-title":"JAMA Otolaryngol Head Neck Surg"},{"issue":"1","key":"9190_CR26","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2023.104094","volume":"45","author":"RB Fujiki","year":"2024","unstructured":"Fujiki RB, Fujiki AE, Thibeault SL (2024) Examining therapy duration in adults with induced laryngeal obstruction (ILO). Am J Otolaryngol 45(1):104094","journal-title":"Am J Otolaryngol"},{"key":"9190_CR27","doi-asserted-by":"publisher","first-page":"44","DOI":"10.3389\/fsurg.2019.00044","volume":"6","author":"A Sandnes","year":"2019","unstructured":"Sandnes A, Hilland M, Volls\u00e6ter M, Andersen T, Enges\u00e6ter I, Sandvik L et al (2019) Severe exercise-induced laryngeal obstruction treated with supraglottoplasty. Front Surg 6:44","journal-title":"Front Surg"},{"issue":"2","key":"9190_CR28","doi-asserted-by":"publisher","first-page":"425","DOI":"10.1007\/s00405-015-3758-7","volume":"273","author":"K Norlander","year":"2016","unstructured":"Norlander K, Christensen PM, Maat RC, Halvorsen T, Heimdal JH, Mor\u00e9n S et al (2016) Comparison between two assessment methods for exercise-induced laryngeal obstructions. Eur Arch Otorhinolaryngol 273(2):425\u2013430","journal-title":"Eur Arch Otorhinolaryngol"},{"issue":"6","key":"9190_CR29","doi-asserted-by":"publisher","first-page":"479","DOI":"10.1016\/j.anorl.2021.02.005","volume":"138","author":"L Giraud","year":"2021","unstructured":"Giraud L, Wuyam B, Destors M, Atallah I (2021) Exercise-induced laryngeal obstruction: from clinical examination to continuous laryngoscopy during exercise. Eur Ann Otorhinolaryngol Head Neck Dis 138(6):479\u2013482","journal-title":"Eur Ann Otorhinolaryngol Head Neck Dis"},{"key":"9190_CR30","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2022.817003","volume":"10","author":"H Clemm","year":"2022","unstructured":"Clemm H, R\u00f8ksund OD, Andersen T, Heimdal JH, Karlsen T, Hilland M et al (2022) Exercise-induced laryngeal obstruction: protocol for a randomized controlled treatment trial. Front Pediatr 10:817003","journal-title":"Front Pediatr"}],"container-title":["European Archives of Oto-Rhino-Laryngology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00405-024-09190-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00405-024-09190-y\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00405-024-09190-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,8]],"date-time":"2025-03-08T19:45:42Z","timestamp":1741463142000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00405-024-09190-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,21]]},"references-count":30,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2025,3]]}},"alternative-id":["9190"],"URL":"https:\/\/doi.org\/10.1007\/s00405-024-09190-y","relation":{},"ISSN":["0937-4477","1434-4726"],"issn-type":[{"value":"0937-4477","type":"print"},{"value":"1434-4726","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,21]]},"assertion":[{"value":"18 November 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 December 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 January 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare that they have no conflict of interest.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"None.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Notation of prior abstract presentation\/publication"}},{"value":"Obtained.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Patient consent for publication"}},{"value":"Protocols for ethical approvals have been submitted and granted. REK has approved to use and analyze patient data from 2013 to 2023 and to send questionnaires to previous patients to assess long-term effect of speech therapy (ID 2016-01898).","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}}]}}